Endometriosis treatment by obstetrician-gynecologist Irina Ivanovna Kulbach in Dnipro.

When addressing complaints of painful menstruation, irregular discharge, lower abdominal pain, or difficulties with conception, it is important for women to receive an accurate assessment of their condition.

The physician conducts a clinical evaluation, carefully reviews the complaints and medical history, and, if necessary, prescribes additional examinations to clarify the causes.

The patient receives a clear action plan: what to do now, which tests to undergo, and how to monitor changes in their condition over time.

Irina Ivanovna Kulbach pays particular attention to the differential diagnosis of symptom causes and ongoing patient management in order to timely adjust treatment and minimize the risk of complications.

When to See a Doctor

If you notice unpleasant symptoms related to discomfort in the pelvic area or disturbances in the reproductive system, it is important to consult an obstetrician-gynecologist to clarify the cause and choose appropriate treatment. You should make an appointment with an obstetrician-gynecologist if you have endometriosis and experience:

• Constant or worsening lower abdominal pain, especially during menstruation
• Occasional pain during sexual intercourse
• Irregular or heavy menstrual bleeding
• A feeling of discomfort or pressure in the pelvic area
• Difficulties conceiving when planning a pregnancy
• Recurrent symptoms after previously prescribed treatment
• Increased pain that interferes with work, sleep, or daily activity
• Lack of improvement despite attempts to alleviate symptoms on your own
• Symptom flare-ups following stressful situations or lifestyle changes
• The appearance of new unusual discharge or changes in your menstrual cycle
• The presence of accompanying gynecological problems or chronic diseases
• The need to monitor your condition following diagnosis or a course of treatment

Each case is individual, and symptoms do not always indicate a severe condition, but it is wise to seek professional advice when they occur. A doctor will help you understand what is happening and develop a consistent plan of action to support your health and comfort.

When in doubt, it is always best to consult a specialist — this will help prevent complications and ensure appropriate management tailored to you.

Emergency Situations or When to Seek Immediate Medical Attention

• Sudden, severe lower abdominal pain that intensifies and does not subside
• Combination of heavy bleeding with general weakness or dizziness
• Sharp rise in body temperature accompanied by body aches and significant worsening of condition
• Sudden onset of severe swelling or redness in the genital area
• Loss of consciousness or severe weakness along with other symptoms

If you experience any of these symptoms, do not wait for a scheduled appointment — seek emergency medical care immediately. In our clinic, it is possible to call a doctor to your home for a rapid assessment and necessary support.

Causes and Risk Factors of Endometriosis

Understanding the possible causes and risk factors helps to better comprehend the nature of endometriosis and determine what should be examined during a medical consultation. It is also important for assessing the condition and planning follow-up care.

Main Causes / Mechanisms (briefly)

• Impaired normal outflow of menstrual blood leading to the displacement of endometrial cells outside the uterus
• Increased tissue sensitivity to hormones and inflammatory processes
• Genetic predisposition often plays a role in the development of the disease
• Immunological changes that may affect the body's ability to control abnormal tissue growth
• Mechanical damage or inflammation in the pelvic area

Risk Factors

• Age between 25 and 40 years, when the disease manifestations are most common
• Having relatives with endometriosis or similar gynecological disorders
• Early onset of menstruation and prolonged menstrual cycles
• Absence of pregnancy or infrequent pregnancies
• Frequent stress and hormonal imbalances
• Certain chronic inflammatory diseases of the pelvic organs
• Unbalanced diet and sedentary lifestyle can worsen symptoms
• Repeated surgeries on pelvic organs

Reversible Causes That Should Be Excluded

• Inflammatory diseases of the pelvic organs that may cause similar symptoms
• Hormonal disorders that can be corrected medically
• Benign growths that require separate examination
• Consequences of inflammations or injuries that can mask endometriosis symptoms

Endometriosis is a complex condition with various causes and risk factors, requiring comprehensive evaluation by a specialist and thorough examination.

Diagnosis

When seeking help for symptoms of endometriosis, the doctor organizes the examination steps to understand the causes of your complaints and develop a further plan. This process helps to assess the condition as accurately as possible and determine the necessary actions.

Approach to Diagnosis

• Taking a detailed medical history: complaints, menstrual cycle characteristics, disease history
• The doctor performs a gynecological examination to assess the condition of the pelvic organs
• Performing basic laboratory tests as indicated to rule out inflammation and other causes
• Ordering additional studies if necessary to clarify the diagnosis
• Analyzing results and developing a preliminary plan for examination and treatment
• Discussing further steps and recommendations for monitoring the condition with the patient

Typical Studies as Indicated

May include:

• Ultrasound examination of the pelvic organs
• Blood and hormone laboratory tests
• Magnetic resonance imaging (MRI) for detailed assessment of tissue structure
• Hysteroscopy or laparoscopy in complex cases and if precise diagnosis is required

What to Bring to the Appointment

• Results of previous examinations and tests
• A list of current and recently taken medications
• Symptom diary, if you keep one
• Information about your menstrual cycle and its characteristics

Diagnosis of endometriosis is a sequential and individualized process that allows selection of the appropriate management and control of the disease course.

Treatment

The treatment of endometriosis aims to reduce symptoms and improve quality of life. The therapy plan is tailored individually, taking into account the specific characteristics of each patient and the results of examinations.

Therapy Goals

• Reduction of pain and discomfort
• Control and slowing down the progression of endometriosis
• Restoration and maintenance of reproductive function, if indicated
• Prevention of complications and associated disorders

Main Treatment Approaches

• May include medication therapy for symptomatic relief and hormonal control
• Use of non-drug methods such as physiotherapy and rehabilitation
• Interventions if indicated to eliminate lesions or complications
• Individualized treatment regimen selection considering comorbid conditions and patient preferences

What the Doctor Does

• Selects and adjusts therapy based on effectiveness and tolerability
• Considers the presence of comorbid diseases for comprehensive management
• Monitors possible side effects and makes necessary changes to the treatment plan
• Explains criteria for evaluating treatment effectiveness and monitoring stages
• Coordinates consultations with other specialists if needed

What to Expect: Plan and Monitoring

• Approximate start of assessing therapy response — individual and as indicated
• Periodic monitoring of symptoms and condition for timely adjustments
• Possibility of changing the treatment plan if the expected effect is not achieved
• Regular doctor visits for observation and support

To develop an individual treatment plan, make an appointment with Dr. Irina Ivanovna Kulbach.

Prevention

Preventive measures help reduce the risk of developing and progressing endometriosis. The prevention plan is tailored individually, taking into account your health characteristics and lifestyle.

Main Primary Prevention Measures

• Maintaining a healthy lifestyle with regular physical activity
• Managing chronic inflammatory diseases of the pelvic area as indicated
• Avoiding harmful habits such as smoking and excessive alcohol consumption
• Consulting with a doctor about hormonal balance adjustments if necessary
• Seeking timely medical advice upon the appearance of any concerning symptoms

Screening and Secondary Prevention / Regular Monitoring

• Regular gynecological examinations as recommended by your doctor
• Ultrasound examination of the pelvic organs when indicated
• Monitoring hormonal levels and inflammatory markers as prescribed by a specialist
• Observing symptom progression and adjusting the prevention plan if needed

Practical Tips

• Discuss an appropriate physical activity regimen with your doctor
• Keep a symptom diary to promptly identify any changes
• Maintain a balanced diet and manage stress levels
• Inform your doctor about any new or worsening symptoms
• Schedule regular visits for health assessment and prevention plan adjustments

Prevention of endometriosis requires attentiveness to your body and regular communication with your healthcare provider to maintain health.

Important to Know

The treatment of endometriosis requires a comprehensive approach and careful attention to the condition of the body. It is necessary to identify the causes and factors that worsen the symptoms, rather than just relieving the pain. Early consultation helps to select the right strategy and reduce the risk of complications or disease progression. Often, long-term monitoring with adjustments to the treatment plan based on the dynamics of the condition is required. It is important to consider the impact of overall lifestyle, stress levels, and comorbidities on the course of endometriosis.

• The goal of treatment is to understand the causes and reduce the influence of triggering factors, not just temporarily alleviate symptoms.
• Timely medical attention helps prevent complications and choose the most appropriate treatment methods.
• The treatment plan is often adjusted during the process to achieve better results.
• The condition may change under the influence of physical strain, emotional state, and other illnesses.
• Self-medication can hinder accurate diagnosis and cause unwanted effects.
• In our clinic, treatment is conducted under the supervision of a single specialist, taking into account all the patient’s individual characteristics.

If you have any questions or need to clarify your condition, it is recommended to schedule a consultation with a doctor. Detailed information about the causes, symptoms, and treatment options for endometriosis can be found on our general page dedicated to this topic.

Self-help Before the Appointment: What You Can and Cannot Do

Before seeing a doctor for endometriosis symptoms, you can take several safe steps to alleviate your condition and prepare for the visit. If your condition worsens, seek urgent help from Dr. Irina Ivanovna Kulbach.

What You Can Do Before the Appointment

• Write down when and how symptoms began: time, circumstances, what increases pain or discomfort
• Keep a symptom diary, noting intensity and possible triggers
• Bring a list of all medications and supplements you are taking to the appointment
• Reduce physical activity and rest to avoid worsening the condition
• Measure and record your temperature and pulse if you know how
• Drink enough water to prevent dehydration
• If needed, take an available pain reliever, provided it is usually safe and has no contraindications
• Monitor your emotional state and minimize stress as much as possible

What You Should Not Do Before the Appointment

• Do not stop taking prescribed medications without consulting your doctor
• Do not start combining new medications or remedies on your own
• Do not use unverified folk remedies that promise quick recovery
• Do not ignore worsening symptoms or sudden increases in pain
• Do not attempt to self-diagnose based on tests or symptoms
• Do not skip the scheduled doctor’s appointment, even if symptoms temporarily subside
• Do not delay seeking medical help if new alarming signs appear

If urgent symptoms arise, immediately seek help from Dr. Irina Ivanovna Kulbach.

How I Can Help as a Doctor with Endometriosis

During a consultation for endometriosis, I will help you comprehensively understand your situation. This approach allows us to identify the causes of your symptoms, assess your condition, and choose the optimal strategy. Taking your individual characteristics into account, we will develop a plan that includes examinations, treatment, and monitoring. During the endometriosis consultation, I can assist you with the following:

• Analyze your symptoms and medical history to identify possible causes
• Assess the severity of your condition and potential risk factors
• Review current prescriptions and evaluate therapy tolerability
• Develop a plan for next steps: examinations, treatment, and monitoring progress
• Consider comorbidities and medications for safe management
• Provide recommendations on lifestyle and daily routine as needed
• Discuss criteria for treatment effectiveness and when to seek follow-up care
• Conduct an initial diagnosis to determine causes and rule out other possible conditions
• Adjust the treatment plan if there is insufficient effect or side effects

This approach not only helps alleviate symptoms but also reduces the risk of complications and exacerbations. The consultation will assist in establishing consistent management and ensure control over your condition at all stages.

What Questions Can You Ask a Doctor About Endometriosis

During a consultation about endometriosis, you can discuss the following issues with Dr. Irina Ivanovna Kulbach:

• Lower abdominal pain and menstrual discomfort
• Irregular or heavy menstrual bleeding
• Discomfort during sexual intercourse
• Problems with conception and pregnancy planning
• Recurring or worsening symptoms despite ongoing treatment
• Questions about therapy adjustments and medication tolerance
• The need for a second opinion or review of previous examinations
• General recommendations on lifestyle and daily routine considering the condition

In case of severe sudden pain, heavy bleeding, or a sharp deterioration in your overall condition — urgent medical care is required; do not wait for a scheduled appointment.

Questions You Can Bring Up During the Consultation

• What is happening to me and what could this be?
• Why have the symptoms appeared just now?
• How can endometriosis be distinguished from other possible causes of pain or disturbances?
• What examinations are needed in my particular case?
• Which tests and investigations are mandatory, and which ones can be skipped?
• How should I prepare for examinations and the doctor’s appointment?
• What treatment options are available and how do they differ?
• Is full recovery possible, or is this a chronic condition?
• Why is the prescribed treatment not working and what should be done next?
• Is it possible to avoid surgeries or other interventions?
• How long does treatment usually last and how often is follow-up required?
• What signs indicate that the condition is improving or worsening?
• What should I do if symptoms suddenly worsen or flare up?

During the appointment, the doctor will address all your questions, conduct an initial assessment, and help develop a plan for examination and treatment. In emergency situations, the doctor will refer you for urgent care or to other specialists to ensure your safety and timely assistance.

How the Consultation Proceeds

A consultation with an obstetrician-gynecologist for endometriosis involves a thorough review of your complaints, an assessment of your condition, and the development of a plan for further action. The scope of examinations is determined individually, based on indications, taking into account your symptoms and medical history. A preliminary evaluation is made during the appointment, with further clarification possible after the necessary tests.

1. Clarification of complaints and the purpose of the visit: when and how symptoms appeared, what aggravates or relieves them, and what you expect from the consultation
2. Collection of medical history with a focus on gynecological issues, menstrual cycle, comorbidities, and risk factors
3. Review of previous examinations and treatments; it is recommended to bring any available test results and a list of medications you are taking
4. Examination of the pelvic organs and other relevant diagnostic tests as indicated, which help to understand the current condition
5. Preliminary conclusion with an explanation of possible causes and what needs to be ruled out at the next stage
6. A plan for further examinations as indicated, which may include ultrasound, blood tests, magnetic resonance imaging (MRI), and additional methods if necessary
7. Discussion of options for further treatment and management, without specific prescriptions at this initial stage
8. Recommendations for monitoring the condition’s progression, timing for follow-up visits, and criteria for seeking earlier consultation

If this is your first consultation, special attention is given to clarifying symptoms and exploring possible causes. In cases where previous treatment did not bring the expected results, we focus on analyzing the reasons and adjusting the approach.

Preparation for the Appointment

For an effective appointment with an obstetrician-gynecologist for endometriosis, it is important to prepare in advance. This will help to establish a preliminary diagnosis faster and create a treatment plan.

• Bring a list of all current medications with their names and dosages, if known
• Take the results of previous examinations, imaging, and tests, including ultrasounds and laboratory tests
• Write down your main complaints: when symptoms appeared, what worsens or alleviates them
• Do not stop taking prescribed medications without consulting your doctor
• If possible, come without makeup or creams on the examination area
• If recommended, come fasting — do not eat or drink for 8–12 hours (if no other instructions, clarify when making the appointment)
• Prepare a list of questions you want to discuss during the appointment
• Bring documents confirming your previous examinations, either originals or copies
• Inform about any changes in your condition or new symptoms since your last visit

If you have any questions regarding preparation, it is best to clarify the details when making the appointment. Do not change your medication regimen without your doctor's approval to avoid harm.

About the Doctor

Irina Ivanovna Kulbach is a highly qualified obstetrician-gynecologist with over 40 years of experience. She works with patients requiring treatment for endometriosis, including primary cases, chronic conditions, and situations where previous treatments have not yielded the expected results.

The doctor's focus is on differential diagnosis of symptom causes and ongoing patient management with regular plan adjustments as needed. During the consultation, you will receive a clear explanation of your situation and recommendations for the next steps, taking into account the individual specifics of your case.

Why Patients Choose Dr. Irina Ivanovna Kulbach

When treating endometriosis, a comprehensive and systematic approach is essential, taking into account the individual characteristics of each patient. Dr. Irina Ivanovna Kulbach places special emphasis on thorough diagnostics of symptom causes and reviewing previous treatments to adjust therapy if the effect is insufficient. Patients appreciate the transparency of the treatment plan and monitoring of effectiveness at every stage, as well as safe management considering comorbidities. Unlike other specialists, Irina Ivanovna focuses on long-term patient support and prevention of flare-ups.

• Clear and step-by-step action plan: from diagnostics to result monitoring
• Examinations are prescribed only when indicated, without unnecessary procedures
• Consideration of comorbidities and drug interactions to ensure safety
• Monitoring the progression of the condition with prompt therapy adjustments when needed
• Review of previous prescriptions and assessment of drug tolerance to optimize treatment
• Detailed explanations of risks and alternative options without complicated terminology
• Emphasis on prevention of complications and exacerbations for stable well-being
• Experience managing complex and combined cases with a comprehensive assessment of the condition

This approach allows patients to clearly understand their course of action and feel supported at every stage of endometriosis treatment.

Case Studies

Initial Consultation with Suspected Endometriosis

A middle-aged patient presented with complaints of regular lower abdominal pain and menstrual cycle irregularities. It was important to exclude other possible causes of the symptoms and to clarify whether they were related to endometriosis. A comprehensive examination was performed, medical history was taken, and necessary tests were ordered as indicated. Based on the results, the initial assumption was confirmed and a plan for further management was developed. After several weeks, the patient’s condition stabilized and symptoms became less severe. Regular monitoring and treatment adjustments as needed were scheduled for the upcoming periods.

Treatment Adjustment in Case of Lack of Effect

A young woman came in with complaints of persistent pain and discomfort following previously prescribed therapy. It was important to analyze the reasons for the ineffectiveness and to rule out other pathologies. A thorough review of symptoms and medical history was conducted, additional examinations were performed, and the tolerance to prescribed medications was assessed. Based on new data, the treatment strategy was adjusted. Over the course of several weeks, there was a gradual reduction in unpleasant sensations and improvement in quality of life. Dynamic monitoring continues with possible further adjustments.

Chronic Course with Comorbidities

A patient with a stable diagnosis of endometriosis sought help due to deterioration of condition against the background of chronic inflammatory diseases. It was important to comprehensively assess the interaction of conditions and the safety of therapy. A detailed medical history was collected, data from other specialists were compared, and current prescriptions were analyzed. A therapy plan was formulated taking into account all comorbid diagnoses. Over the course of a month, symptom stabilization and control of inflammatory processes were observed. Supportive monitoring and regular assessment of the condition continue thereafter.

Symptom Exacerbation and Prevention Plan

A middle-aged woman presented with a sudden increase in pain and general malaise. It was crucial to promptly exclude serious complications and determine the next steps. An emergency examination and necessary investigations were conducted, and a strategy for managing the exacerbation was developed. According to symptom dynamics, the condition improved and the pain became manageable. A prevention program was devised, including regular check-ups and measures to reduce the risk of new exacerbations. A follow-up visit to assess the effectiveness of preventive measures was scheduled.

Second Opinion and Review of Examinations

A patient sought a second opinion regarding previous examinations and treatment of endometriosis. It was important to objectively assess the quality of diagnosis and the potential for therapy adjustment. All submitted documents were analyzed and the medical history was discussed. Additional diagnostic methods were proposed to clarify the disease picture. Afterwards, recommendations for management and monitoring of the condition were formulated. Following observations noted an improvement in well-being and clarity in further management. Ongoing follow-up and support continue.

How long does a consultation last?

On average, a consultation takes 30–60 minutes. Please confirm the exact duration when booking.

How should I prepare for the appointment?

It is recommended to write down your main complaints, prepare a list of medications you are taking, and bring any test results.

What should I bring to the appointment?

Bring your test results, imaging scans, discharge summaries, and a list of all medications with dosages.

Do I need to come on an empty stomach?

Usually, fasting is not required unless the doctor specifies otherwise when you book the appointment.

How many visits are usually required for treatment?

The number of visits depends on the situation and chosen treatment strategy and is discussed individually.

When can I expect the first results of the treatment?

Initial changes are assessed individually, depending on the therapy and the body’s response.

What should I do if my condition worsens before the appointment?

If serious symptoms appear, such as severe pain or bleeding, seek urgent medical attention.

Can treatment be combined with my current medications?

Discuss all medication use with your doctor; do not change or stop any medications on your own.

Is it possible to get an online consultation?

Yes, online consultations are available, including symptom discussion and recommendations.

Can I come with already completed tests?

Yes, bring all available test results for a comprehensive assessment.

Do I need to come for follow-up visits and how often?

Follow-up visits are planned based on treatment effectiveness and condition progress.

Can I get a second opinion on treatment and tests?

Yes, the doctor will review all questions and help analyze previous prescriptions.

What should I do if symptoms return after improvement?

Contact your doctor for additional evaluation and treatment plan adjustment.

What tests are usually necessary?

The list of tests is determined individually based on indications and discussed during the appointment.

How do I prepare for tests?

Specific preparation depends on the type of test; your doctor will provide instructions.

Can I bring a child to the appointment?

If necessary, confirm the possibility when booking; conditions depend on the clinic.

What safety measures are followed in the clinic?

The clinic adheres to all hygiene and safety standards for patients.

How soon can I book a consultation?

Booking times depend on availability; it is recommended to check available dates in advance.